6 professional fee coding auditor jobs found in Washington

Connecticut Institute for Communities, Inc. Description: The Team Lead will oversee key components of the revenue cycle including Internal and Outsourced Billing Services and Financial & Insurance Assistance. Serves as the organizations internal lead for oversight of both outsourced billing vendor and internal patient billing activities, including self-pay and sliding fee accounts. This role ensures patients have timely access to insurance enrollment and financial assistance services while maintaining strong internal controls, accurate patient billing processes, vendor accountability, and compliance with healthcare billing and payer requirements. ESSENTIAL JOB RESPONSIBILITIES: Revenue Cycle Oversight: Serve as the primary internal liaison between CIFC Health and the outsourced billing vendor. Monitor revenue cycle performance metrics, including claim submission timeliness, denial trends, accounts receivable aging, and collections. Review billing and...

Requirements Review E/M services under 2021+ guidelines MUST RESIDE IN FLORIDA AND HAVE CODING AND AUDITING EXPERIENCE. Deposition as well as Testimony experience is preferred. We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Florida-based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupments Prepare written audit findings and defensible reports Provide expert support for depositions and testimony as...

Review E/M services under 2021+ guidelines MUST RESIDE IN NEVADA AND HAVE CODING AND AUDITING EXPERIENCE. Deposition as well as Testimony experience is preferred. Requirements We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Nevada-based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupments Prepare written audit findings and defensible reports Provide expert support for depositions and testimony as needed Review...

Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura's Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research...

Summary We are seeking a highly skilled, hands-on Medical Bill Review (Working) Supervisor to lead our day-to-day bill review operations while actively participating in complex case reviews and serving as a key resource for our legal services division. In this dual-capacity role, you will manage a small team of bill reviewers and maintain a production workload focused on high-dollar, complex medical bill review/legal cases. You will leverage an intimate knowledge of major medical bill review software and national repricing/payer systems, ensuring absolute accuracy in identifying excessive or unsupported charges, determining reasonable reimbursement amounts, and defending those findings in litigation. Crucially, you will serve as a Subject Matter Expert (SME) and Expert Witness for legal proceedings, providing forensic billing analyses, affidavits, and deposition/trial testimony. This is a national role; however, Texas-specific expertise is preferred in billing regulations,...

Description Medical Coder Venesco LLC is seeking a Medical Coder to perform clinical coding activities for adverse events, medical histories, procedures, and concomitant medications for FDA-regulated clinical trials, ensuring consistency, accuracy, and regulatory compliance. Requirements Duties and Responsibilities Code adverse events using MedDRA terminology. Code medications using WHO Drug Dictionary. Develop coding conventions and coding guidelines. Review CRFs and contribute to data review activities. Perform coding reconciliation activities. Generate coding reports and quality control reviews. Support database testing and validation activities. Conduct coding-related training for study personnel. Maintain coding documentation and audit trails. Support regulatory submissions and database lock activities. Minimum Qualifications Bachelor's degree in Health Sciences, Clinical Research, Nursing, Pharmacy, or related discipline. MedDRA Certified and WHO-Drug Certified. Minimum 7...